Skip to content
flowss
Start freeChecking your session
Decision tree templates

Decision Tree — Atrial Fibrillation Anticoagulation (QALYs)

A clinical decision analysis in quality-adjusted life years: a direct oral anticoagulant, aspirin or no therapy for atrial fibrillation with a CHA₂DS₂-VASc score of 2, with stroke severity, intracranial and extracranial bleeds — the DOAC arm rolls back to 7.129 QALY, 0.115 QALY ahead of aspirin. Illustrative values for teaching, not clinical guidance.

Decision treeResearch & AcademicDecision tree syntax docs
Template previewDecision tree
Atrial fibrillation, CHA₂DS₂-VASc 2 — which stroke prevention?Atrial fibrillation, CHA₂DS₂-VASc 2 — which stroke prevention?Quality-adjusted life years over a 10-year horizon, discounted at 3.5%1 decision · 6 chance nodes · 14 outcomes · maximise expected valueOPTIMAL STRATEGYDirect oral anticoagulant·EV 7.129 QALYAspirinNo antithrombotic therapyIschaemic stroke15%Intracranial haemorrhage1%Major extracranial bleed7%No major event77%Disabling40%Non-disabling60%Ischaemic stroke17%Major bleed6%No major event77%Disabling40%Non-disabling60%First event on aspirinEV 7.014 QALYStroke severityEV 5.280 QALY3.90 QALY6.20 QALY4.10 QALY6.90 QALY7.40 QALYFirst event untreatedEV 7.010 QALYStroke severityEV 5.280 QALY3.90 QALY6.20 QALY6.90 QALY7.40 QALYDirect oral anticoagulantIschaemic stroke7%Intracranial haemorrhage2%Major extracranial bleed8%No major event83%Disabling40%Non-disabling60%Stroke preventionEV 7.129 QALYFirst event on a DOACEV 7.129 QALYStroke severityEV 5.280 QALY3.90 QALYP 2.8%6.20 QALYP 4.2%4.10 QALYP 2%6.90 QALYP 8%7.38 QALYP 83%DecisionChanceOutcomeOptimal strategyRejected alternativeRisk profile·cumulative probability by first choice0%25%50%75%100%3.54.04.55.05.56.06.57.07.5final outcome, net of costs (QALY)FIRST CHOICEEVDirect oral anticoagulant7.129 QALYσ 0.754 QALY · worst 3.90 QALYAspirin7.014 QALYσ 0.918 QALY · worst 3.90 QALYNo antithrombotic therapy7.010 QALYσ 0.918 QALY · worst 3.90 QALYWhat the rollback showsBest first choice: “Direct oral anticoagulant”, EV 7.129 QALY — 0.115 QALY ahead of the next best, “Aspirin” (7.014 QALY).Following it, the outcome ranges from 3.90 QALY to 7.38 QALY across 5 possible results, standard deviation 0.754 QALY.Note: Event risks are cumulative over the horizon and each branch is the first major event; the DOAC arm carries a 0.02 QALY treatment burden.Note: Illustrative values for teaching — not clinical guidance.

Make it your own.

title "Atrial fibrillation, CHA₂DS₂-VASc 2 — which stroke prevention?"
subtitle "Quality-adjusted life years over a 10-year horizon, discounted at 3.5%"
unit QALY
probabilities percent
risk-profile compare
note "Event risks are cumulative over the horizon and each branch is the first major event; the DOAC arm carries a 0.02 QALY treatment burden."
note "Illustrative values for teaching — not clinical guidance."

decision "Stroke prevention"
  "Direct oral anticoagulant" -> chance "First event on a DOAC"
    "Ischaemic stroke" p 7%
      chance "Stroke severity"
        "Disabling" p 40% -> 3.9
        "Non-disabling" p rest -> 6.2
    "Intracranial haemorrhage" p 2% -> 4.1
    "Major extracranial bleed" p 8% -> 6.9
    "No major event" p rest -> 7.38
  "Aspirin" -> chance "First event on aspirin"
    "Ischaemic stroke" p 15%
      chance "Stroke severity"
        "Disabling" p 40% -> 3.9
        "Non-disabling" p rest -> 6.2
    "Intracranial haemorrhage" p 1% -> 4.1
    "Major extracranial bleed" p 7% -> 6.9
    "No major event" p rest -> 7.40
  "No antithrombotic therapy" -> chance "First event untreated"
    "Ischaemic stroke" p 17%
      chance "Stroke severity"
        "Disabling" p 40% -> 3.9
        "Non-disabling" p rest -> 6.2
    "Major bleed" p 6% -> 6.9
    "No major event" p rest -> 7.40